Severe obesity is a major health risk that can decrease life expectancy and give rise to a number of other associated ailments, including the onset of cardiovascular disease, hypertension, diabetes and severe arthritis. A number of surgical procedures can be performed to aid in the treatment of obesity. The most common procedure is a gastric restriction procedure in which opposed gastric walls are fastened or stapled together to effectively reduce the volume of a patient's stomach. More specifically, the stomach is divided by a series of staples or fasteners that extend vertically for about 2.5 inches to create a smaller stomach pouch. The outlet of the pouch into the larger stomach limits the amount of food the stomach can hold and reduces the rate of gastric emptying.
Some gastric restriction procedures utilize a series of fasteners that are coupled by a suture used to cinch and pull the fastened tissue together. Suture-coupled fasteners offer the advantage of allowing the fasteners to be applied to each wall of the stomach separately, and then to be cinched together using the suture after the fastener applying device is removed. In order to apply staples, on the other hand, folds must be created in each wall to engage and pull the tissue together, thus requiring that the staples be inserted through four walls of tissue.
While suture-coupled fasteners tend to be more advantageous than staples, slack or loops of excess suture can form as the surgeon is attaching the fasteners to the opposed walls of the stomach. For the gastric restriction procedure to be successful, the suture must be tightly cinched to pull the gastric walls together so that the reduced volume of the patient's stomach can be maintained. If any slack or loose loops of suture are present, the stomach will expand and the restriction procedure will not be effective. Thus, the surgeon must manually maintain tension on the suture as the fasteners are being applied. This can be difficult though, as most fastener delivery devices tend to require two hands to operate.
Accordingly, a need exists for devices and techniques for tensioning a length of suture.